CoA PSG www.coapsg.org Karen Monarchy Rowe, Executive Director

Ph: 252-626-3238 Email: karenmonarchy@suddenlink.net or

office@coapsg.org

History Became a CAAHEP member in 2003 First CAAHEP programs accredited 07/2006 Currently 2 Sponsors: American Association of Sleep Technologists

(AAST) Board of Registered Polysomnographic

Technologists (BRPT)

Our Progression • OJT – no formal education • Certificate/Diploma – with possible higher

transitioning • Associate Degree • Bachelor Degree • Currently have 42 programs/with a couple

Initials

The Future

• A growing need for sleep technologists and field advancement: o Educators o Researchers o DME providers o Lab Managers

Challenges

oNeed RPSGT credentialed/degreed professionals

oAttrition rate and the increasing need for professional sleep technologists

oHigher education via accreditation/transition

oSignificant state regulatory laws

Polysomnography What is it? The allied health specialty involving the process of attended and unattended monitoring, analysis, and recording of physiological data during sleep and wakefulness to assist in the assessment of sleep and wake disorders and other sleep disorders, syndromes, and dysfunctions that are sleep-related, manifest during sleep, or disrupt normal sleep and wake cycles and activities.

What do we do? Monitor physiological parameters – very inclusive test process Time spent – approximately 10 hrs-3 days – direct patient to tech ratio

What can be determined?

Sleep disorders: Over 100 identified Sleep apnea – most publicized/common 1 in 3

Why do we need this test •Our lives are a mess! – Always

on the go •Our pillars of health: oNutrition oExercise oSLEEEEEEPPPP!!!!!!!!!!!!!!

Humans – Really? – Why? • Only species – CHOOSES NOT to sleep

o #1 reason: We are TOO BUSY – Right? o Everything else gets our time, except our bodies o OR, we have a sleep disorder which may include

Inability to sleep too little or too much Intrinsic body issues: such as Neurological

diseases(since sleep occurs in the brain) Injuries/pain/comorbid diseases/medications/ shift

work/kids/technological advances – hum………This is a biggee

Sleep Disorder(s) anyone?

OKAY -----------

Who in this room has a sleep disorder?

A very extensive field

I’m going to jump ahead to some very common issues of importance for today

Sleep Apnea Chronic/Serious Disease • 1 in 3 – take a look around you • Do you experience any of these problems?

o Unintentionally falling asleep during the day o General day time sleepiness o Unrefreshing sleep o Fatigue o Insomnia

• Do you ever wake from sleep with a choking sound or gasping for breath?

• Has your bed partner noticed that you snore loudly or stop breathing while asleep?

(continued) Other questions that may indicate a high risk for

apnea: Nodding off while driving Often wake up with a headache Have a neck size of 17 inches or more Have a body mass index (BMI) of 25 or higher Have high blood pressure Have a family member who has sleep apnea

The Epworth Sleepiness Scale is used to help determine the likelihood of sleep apnea

Sleep Apnea/Risks Independently associated with an increased

risk of stroke, cancer, and death Moderate to severe sleep apnea makes you 4

times more likely to die when the sleep disorder is left untreated in the long term

See a physician if you have any of these symptoms

Treatment: Continuous Positive Airway Pressure (CPAP); or variations

INSOMNIA --- YIKES!!

• Aside from sleep apnea, this is the most common sleep complaint (30-35% of adults)

• Symptoms: o Difficulty falling asleep o Difficulty maintaining sleep o Waking up too early in the morning

(continued)

• Insomnia involves both a sleep disturbance and daytime symptoms.

• Negatively affects: o Work performance o Impairs decision making o Damage relationships

Destroys quality of life

(continued) Everyone has insomnia from time to time. • Two types of insomnia

oShort-term: Lasts up to 3 months(jet lag – the constant traveler – crossing time zones)

oChronic: 3 times/week/minimum of 3 months

Insomnia – Symptoms • Symptoms:

o Fatigue o Cognitive o Poor performance o Moodiness/Irritability o Daytime Sleepiness o Impulsiveness/aggression o Lack of energy/motivation o Errors or accidents o Mounting frustration over not sleeping

Insomnia - Causes • Insomnia most often associated with another

problem such as: o Stress o Other sleep disorders o Medical conditions (pain/lack of mobility/pregnancy/

menopause/Parkinson’s) o Mental Disorders (depression is the most common/

anxiety/bipolar disorders) o Medication or Substance Abuse (OTC – cold meds/allergy/

antidepressants/blood pressure meds/caffeine/nicotine/) o Environmental Factors (noise/light/extreme temperatures/

chemicals/bed partners – including the pets) o Habits and lifestyle (constant irregular sleep schedule)

Insomnia – Diagnosis • Longer than 30 minutes to fall asleep/wake up

during the night • Daytime symptoms: sleepy and tired • Time in bed: Do you get at least 7 hours of

sleep?!?!? • Safe and good environment to sleep well Self-Test Keep a Sleep Diary

Insomnia – Treatment • Good sleep Hygiene • Cognitive Behavioral Therapy

(stress reduction/relaxation/ schedule)

• Medications: Adjustment of medications

Drowsy Driving – Impaired Driving

Drowsy driving is a form of impaired driving that negatively affects a person to drive safely. Most people associate impaired driving with alcohol or drugs, but in this situation, SLEEPINESS is the primary cause.

Educators/Students/Employers • Our schools/institutions need to incorporate

sleep education • Students are suffering in many ways:

o Sleep disorders o Underlying health conditions o Suffering in academics/severe drop in cognitive

learning o Unbelievable lifestyle schedules:

Academics – advanced placement courses/heavy curriculums

Extracurricular activities – sports/social life/friends Technology – too much stimulation/not enough rest

What can we do – as parents? oAs parents

Be aware – not tired – they are seriously sleep deprived Set limits Set established bedtime hours Follow good Sleep Hygiene

As Educators? Encourage later and more

desirable start and finish times for schools/colleges/classes Be flexible Allow sleep !! ESPECIALLY if this student is coming or leaving class via a vehicle

As Employers Companies that allow sleep: Google, Nike, Zappos, Ben and Jerry’s, NASA, Huffington Post Encourage sleep pods/nap rooms/etc.

Advocate, advocate, advocate

• Raise the awareness to everyone • Sleep is a pillar of health!

Sleep Fun Facts • Only ½ of a dolphin’s brain goes to sleep at a time • Lack of sleep can cause weight gain of 2 lbs. in under a

week • You burn more calories sleeping, than you do watching

TV • Before alarm clocks there were “knocker-ups” that came

by with a stick to tap on your window to wake you • A snail can sleep for 3 years • Giraffes need 5-30 minutes of sleep in 24 hour period • It’s impossible to sneeze while sleeping • Morphine derives its name from Morpheus, the god of

sleep

And my favorite fact!

•Sea otters hold hands when they sleep so they don’t drift away from each other

Additional References on Polysomnography

http://www.nhtsa.gov/Driving+Safety/Drowsy+Driving/ci.Research+on+Drowsy+Driving.print National Highway Traffic Safety Administration – this is a great article !

https://med.stanford.edu/news/all-news/2015/10/among-teens-sleep-deprivation-an-

epidemic.html - A MUST READ about teens and sleep http://www.narcolepsynetwork.org/wp-content/uploads/2010/05/ESS_Form-052210.pdf – Sleepiness

scale http://yoursleep.aasmnet.org/pdf/sleepdiary.pdf – Sleep Diary – should be completed in advance of

seeing a sleep physician http://www.lmep.com/Portals/9/KBase/Patient%20Ed/Sleep%20Problems-

Disorders/Pediatric%20Daytime%20Sleepiness%20Scale.pdf - Pediatric Daytime Sleepiness Scale http://www.sleepforscience.org/resources/news.php – This provides you with articles by Dr. Mary

Carskadan – she is really good! http://www.sleepeducation.org/essentials-in-sleep/shift-work - Interesting read, great for anyone

that works shifts or irregular hours (health care, safety personnel, manufacturing, etc.)